How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $28.18 Median $38.02 Typical High $131.83 | Facility | None | $28.18 | $38.02 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $61.66 Typical High $131.83 | Professional | None | $28.18 | $61.66 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $70.79 Typical High $134.90 | Professional | None | $30.20 | $70.79 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $29.51 | Professional | None | $26.92 | $29.51 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $67.61 Typical High $97.72 | Professional | None | $23.44 | $67.61 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $134.90 | Professional | None | $95.50 | $107.15 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | None | $89.13 | $89.13 | $95.50 |
Medcost Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $173.78 | Facility | None | $50.12 | $60.26 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Sentara Setting Facility Modifier None Typical Low $23.99 Median $42.66 Typical High $10,232.93 | Facility | None | $23.99 | $42.66 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $46.77 Median $89.13 Typical High $125.89 | Professional | None | $46.77 | $89.13 | $125.89 |
United Setting Facility Modifier None Typical Low $251.19 Median $275.42 Typical High $616.60 | Facility | None | $251.19 | $275.42 | $616.60 |
United Setting Professional Modifier None Typical Low $21.38 Median $46.77 Typical High $77.62 | Professional | None | $21.38 | $46.77 | $77.62 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $30.90 Typical High $66.07 | Professional | 52 · Reduced service | $14.13 | $30.90 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $12.30 Typical High $26.30 | Professional | 53 · Discontinued | $5.62 | $12.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $9.33 Typical High $19.95 | Professional | 55 · Aftercare only | $4.27 | $9.33 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $6.17 Typical High $13.18 | Professional | 56 · Pre-op care only | $2.82 | $6.17 | $13.18 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Virginia sits
The same service costs 3.5 times more in Hawaii than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 42nd of 51
$48.98
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.